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Those seeking treatment for mental health or substance abuse issues often do not get good care. That’s according to a new report from the Institute of Medicine.

“We don’t have unified standards for training the workforce to provide these interventions, and the level of skill needed isn’t always present,” said Sarah Hudson Scholle of the National Committee for Quality Assurance, who helped write the report.

The report is meant to provide a framework for the mental health field to move forward — to start using “evidence-based” approaches — gold standard of care.

Scholle said a lot of different groups will have to work together to achieve progress.

“For an intervention to be effective in the real world, we need for people to be willing to participate in it, we need providers who are trained to participate, and payers who are willing to pay for an intervention,” she explained.

Pulling consumers and families into conversations for feedback and guidance will be crucial, she said.

This issue of great variations in quality of care has plagued the field for a long time, and there have been national initiatives for more evidence-based care in the past.

“There’s long been a lack of coordination between mental and physical health care providers, and no communication between providers,” said Scholle. “There’s been stigma, and people don’t want to seek care from special providers, and so I do think those have contributed but the problems.”

Scholle said that the Affordable Care Act is creating a unique opportunity for change because it emphasizes patient outcomes — and insurance providers have to pay for more mental health treatments.